Kagamihara Yasuhiro, Hayashi Akito, Masakado Yoshihisa, Kouno Yutaka
Department of Neurology, Tokyo Metropolitan Neurological Hospital, Musashidai 2-6-1, Fuchu City, 183-0042, Tokyo, Japan.
Exp Brain Res. 2003 Jul;151(1):136-44. doi: 10.1007/s00221-003-1436-2. Epub 2003 May 13.
The present study was designed to examine the effects of median nerve stimulation on motoneurones of remote muscles in healthy subjects using H-reflex, averaged EMG and PSTH methods. Stimulation of the median nerve induced facilitation of soleus H-reflex from about 50 ms and it reached a peak at about 100 ms of conditioning-test interval. Afferents that induced the facilitation consisted of at least two types of fibres, the high-threshold cutaneous fibres and the low-threshold fibres. When the effects were examined by the averaged surface EMG and PSTH, no facilitation but rather inhibition or inhibition-facilitation was induced in all tested muscles except for the upper limb muscles on the stimulated side. The inhibition latency was shortest in masseter muscle and longest in leg muscles, while values for the contralateral upper limb muscles were in the middle, indicating that the onset of inhibition was delayed from rostral to caudal muscles. Inputs from the median nerve converged to inhibitory interneurones, which mediate the masseter inhibitory reflex. Our findings suggested that inputs from the median nerve initially ascend to the brain, at least to the brainstem, and then descend to the spinal cord. Therefore, inhibition induced by median nerve stimulation was not considered as an interlimb reflex mediated by a propriospinal pathway, but long-loop reflex, at least via the pons. The discrepancy between the results of reflex and motor units suggests that facilitation of soleus H-reflex following median nerve stimulation was mainly due to reduced presynaptic inhibition.
本研究旨在使用H反射、平均肌电图和脉冲刺激时间直方图方法,研究正中神经刺激对健康受试者远端肌肉运动神经元的影响。刺激正中神经在约50毫秒时诱导比目鱼肌H反射易化,并在条件-测试间隔约100毫秒时达到峰值。诱导易化的传入神经至少由两种纤维组成,即高阈值皮肤纤维和低阈值纤维。当通过平均表面肌电图和脉冲刺激时间直方图检查其效应时,除了受刺激侧的上肢肌肉外,在所有测试肌肉中均未诱导易化,而是诱导了抑制或抑制-易化。抑制潜伏期在咬肌中最短,在腿部肌肉中最长,而对侧上肢肌肉的值处于中间,表明抑制的起始从头部肌肉到尾部肌肉延迟。正中神经的输入汇聚到抑制性中间神经元,其介导咬肌抑制反射。我们的研究结果表明,正中神经的输入最初上升到大脑,至少到脑干,然后下降到脊髓。因此,正中神经刺激诱导的抑制不被认为是由脊髓固有通路介导的肢体间反射,而是长环反射,至少通过脑桥。反射和运动单位结果之间的差异表明,正中神经刺激后比目鱼肌H反射的易化主要是由于突触前抑制的降低。